Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/163276
Title: Risk stratification of women with gestational diabetes mellitus using mutually exclusive categories based on the International Association of Diabetes and Pregnancy Study Groups criteria for the development of postpartum dysglycaemia: a retrospective cohort study
Authors: Dai, Fei
Mani, Hemaavathi
Syaza Razali Nurul
Tan, Kok Hian
Keywords: Science::Medicine
Issue Date: 2022
Source: Dai, F., Mani, H., Syaza Razali Nurul & Tan, K. H. (2022). Risk stratification of women with gestational diabetes mellitus using mutually exclusive categories based on the International Association of Diabetes and Pregnancy Study Groups criteria for the development of postpartum dysglycaemia: a retrospective cohort study. BMJ Open, 12(2), e055458-. https://dx.doi.org/10.1136/bmjopen-2021-055458
Project: IPRAMHO/CGAug16C008 
Journal: BMJ Open 
Abstract: Objectives: Women with gestational diabetes mellitus (GDM) are more predisposed to develop postpartum diabetes mellitus (DM). This study aimed to estimate the relative risk (RR) of postpartum dysglycaemia (prediabetes and DM) using mutually exclusive categories according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria cut-off points in patients with GDM, so as to establish a risk-stratification method for developing GDM management strategies. Design, setting and participants: In this retrospective cohort study, 942 women who had been diagnosed with GDM (IADPSG criteria) at 24-28 weeks of gestation from November 2016 to April 2018 underwent a 75 g oral glucose tolerance test (OGTT) at 6-12 weeks postpartum in a tertiary hospital of Singapore. Seven mutually exclusive categories (three one timepoint positive categories (fasting, 1 hour and 2 hours), three two timepoint positive categories (fasting+1 hour, fasting+2 hours and 1 hour+2 hours) and one three timepoint positive category (fasting+1 hour+2 hours)) were derived from the three timepoint antenatal OGTT according to the IADPSG criteria. To calculate the RRs of postpartum dysglyceamia of each mutually exclusive group, logistic regression was applied. Results: 924 mothers with GDM, whose mean age was 32.7±4.7 years, were mainly composed of Chinese (45.4%), Malay (21.7%) and Indian (14.3%) ethnicity. The total prevalence of postnatal dysglycaemia was 16.7% at 6-12 weeks postpartum. Stratifying subjects into seven mutually exclusive categories, the RRs of the one-time, two-time and three-time positive groups of the antenatal OGTT test were 1.0 (Ref.), 2.0 (95% CI=1.3 to 3.1; p=0.001) and 6.7 (95% CI=4.1 to 10.9; p<0.001), respectively, which could be used to categorise patients with GDM into low-risk, intermediate-risk and high-risk group. Conclusions: Mutually exclusive categories could be useful for risk stratification and early management of patients with prenatal GDM. It is plausible and can be easily translated into clinical practice.
URI: https://hdl.handle.net/10356/163276
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2021-055458
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Rights: © Author(s) (or their employer(s)) 2022. Published by BMJ. Open access. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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